Correlation Between Serum Ferritin Level And Preeclampsia And Its Pregnancy Outcome

Objective:To analyze the correlation between serum ferritin level and preeclampsia and its clinical indicators in pregnant women,and the relationship between serum ferritin level and pregnancy outcome.To explore the value of serum ferritin in assessing the severity of preeclampsia.Methods:4872 pregnant women who deliveried in the obstetric department of the Affiliated Hospital of Qiingdao University from December 01,2018 to August 31,2019were retrieved using the medical data system.According to the ninth edition of“Obstetrics and Gynecology”,95 women with preeclampsia were screened out as preeclampsia group(group A).It divided into mild preeclampsia group(A1 group,A total of 43 people)and severe preeclampsia group(group A2,A total of 52 people).At the same time,a total of 1244 non-pre-eclampsia pregnant women meeting the criteria were selected to form the control group(group B).Using Excel spreadsheets for data statistic summary,analysis group A1,A2 and group B in the maternal age,delivery gestational age,body mass index before pregnancy,body mass index before delivery by SPSS20.0software system.Compare between different groups,such as serum ferritin,hemoglobin,and biochemical indicators(alanine transaminase,aspartate aminotransferase,lactate dehydrogenase,creatinine,uric acid,etc.).The correlation between serum ferritin and the above indicators was analyzed,and the correlation between serum ferritin and gestational complications and pregnancy outcomes including gestational diabetes,preterm delivery,premature rupture of membranes,placental abruption,postpartum hemorrhage,fetal distress,birth defects,and children younger in each group was compared and analyzed.Results:(1)Comparison of general clinical conditions of pregnant women:Delivery gestational age of group A were smaller than that of group B,with statistically significant difference(t=4.04,P<0.05).Compared with group B,delivery gestational age of group A1 and group A2 were smaller than that of group B(P<0.05),and delivery gestational age of group A2 were significantly smaller than that of group A1(P<0.05).Pre-pregnancy body mass index(BMI)(P<0.05),body mass index(BMI)before delivery(P<0.05),systolic blood pressure(P<0.05),and diastolic blood pressure(P<0.05)of group A were higher than in group B,A1 and A2 group respectively in group B,BMI before pregnancy,BMI before labor,systolic pressure,diastolic blood pressure were higher than group B(P<0.05).A1 and A2 group to compare differences had no statistical significance(P>0.05).There was no statistically significant difference in age between groups A and B(P>0.05).Pre-pregnancy BMI(r=0.235,P<0.05)and pre-delivery BMI(r=0.259,P<0.05)were significantly correlated with the incidence of preeclampsia.(2)Comparison of serum ferritin and index ratio in bedside test:Serum ferritin(SF)in group A was significantly higher than that in group B,and the difference was statistically significant(t=2.89,P<0.05),group A2 was higher than group A1(P<0.05).Compared with group B,SF in group A1 and A2 was higher than that in group B(P<0.05).Hb in group A was slightly higher than that in group B,but the difference was not statistically significant(t=0.79,P>0.05).Lactate dehydrogenase(LDH),fasting blood glucose(FPG),aspertate aminotransferase(AST),alanine aminotransferase(ALT),creatinine(Scr),uric acid(UA)in group A,were significantly higher than that of group B(P<0.05).A1 and A2 group respectively in group B,LDH,FPG,AST,ALT and UA were higher than in group B(P<0.05),while only A2 Scr is higher than B group(P<0.05),and UA in group A2 was higher than that in group A1(P<0.05),the other examination index in group A compared differences no statistical significance(P>0.05).There was a significant correlation between SF(r=0.338,P<0.05)and preeclampsia.After excluding SF interference,LDH(r=0.251,P<0.05),FPG(r=0.294,P<0.05),AST(r=0.278,P<0.05),ALT(r=0.228,P<0.05),Scr(r=0.177,P<0.05),and UA(r=0.537,P<0.05)were significantly correlated with preeclampsia,but there was no correlation between Hb and preeclampsia(P>0.05).(3)Correlation analysis between serum ferritin and clinical test index:After removing PE interference,there was a significant correlation between SF and Hb(r=0.426,P<0.05),FPG(r=0.351,P<0.05),UA(r=0.365,P<0.05),but no correlation between SF and LDH,AST,ALT and Scr(P>0.05).(4)Comparison of pregnancy complications and pregnancy outcomes:The preterm birth rate in group A was higher than that in group B,with statistically significant differences(x~2=14.700,P<0.05).Preterm birth rate in group A1 and A2 was higher than that in group B(P<0.05),and preterm birth rate in group A2 was higher than that in group A1(P<0.05).The incidence of placental abruption in group A was significantly higher than that in group B(x~2=16.356,P<0.05),the incidence of placental abruption in group A1 group A2 was also higher than that in group B(P<0.05).The rate of postpartum hemorrhage in group A was significantly lower than that in group B(x~2=9.975,P<0.05),and the rate of postpartum hemorrhage in group A1 was significantly lower than that in group B(P<0.05).There was no significant difference in the incidence of gestational diabetes,placental abruption and premature rupture of membranes between group A and group B or within group A(P>0.05).The birth rate of children younger than gestational age in group A was higher than that in group B,and the difference was statistically significant(x~2=9.519,P<0.05).The birth rate of children younger in group A2 was significantly higher than that in group B and group A1(P<0.05).There was no significant difference between the birth rate of children younger in group A1 and group B(P>0.05).The incidence of fetal distress and neonatal asphyxia in A2 group was significantly higher than that in B group(P<0.05).There was no significant statistical significance in the comparison of neonatal birth defects between each group(P>0.05).(5)Correlation analysis between serum ferritin and pregnancy complications and pregnancy outcomes:After removing PE interference,SF and gestational diabetes mellitus(r=0.422,P<0.05),placental abruption(r=0.299,P<0.05),preterm birth(r=0.180,P<0.05),fetal distress(r=0.168,P<0.05)significant correlation was found,and with premature rupture of membranes(r=-0.117,P>0.05),postpartum hemorrhage(r=-0.022,P>0.05),neonatal asphyxia(r=0.075,P>0.05),small of gestational age(r=0.149,P>0.05),birth defects(r=0.060,P>0.05)were no correlation.Conclusion:(1)Serum ferritin levels in pregnant women were significantly correlated with preeclampsia.(2)Serum ferritin levels in pregnant women were positively correlated with hemoglobin levels,fasting blood glucose levels and uric acid levels.(3)Elevated serum ferritin levels in pregnant women were associated with some pregnancy complications and adverse pregnancy outcomes in preeclampsia.(4)Serum ferritin levels may be useful in assessing the severity of preeclampsia.